Individual provider Active NPI

Cynthia Koskiewicz, LCPC

  • Professional Counselor
  • Glen Ellyn, IL
National Provider Identifier
1225301930
Registry record updated Dec 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180008100 Issued in IL
Practice address
526 Crescent Blvd
Suite 324
Glen Ellyn, IL 60137-4176
Phone
(630) 750-6463
NPI assigned
Feb 13, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 29312 IL
Professional Counselor 101YP2500X 180008100 IL Primary

Addresses

Primary practice location

526 Crescent Blvd
Suite 324
Glen Ellyn, IL 60137-4176

Mailing address

526 Crescent Blvd
Suite 324
Glen Ellyn, IL 60137-4176
Phone (630) 750-6463

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
29312ILMDAddiction (Substance Use Disorder) Counselor
180008100ILMDProfessional Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1329091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354665600000",
    "number": "1225301930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "526 CRESCENT BLVD",
            "address_2": "SUITE 324",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601374176",
            "telephone_number": "630-750-6463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "526 CRESCENT BLVD",
            "address_2": "SUITE 324",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601374176",
            "telephone_number": "630-750-6463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSKIEWICZ",
        "first_name": "CYNTHIA",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-13",
        "last_updated": "2012-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "29312",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180008100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Ellyn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.